Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $3,548.13	Facility		$1,513.56	$1,513.56	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,202.26 / $2,041.74	Professional		$977.24	$1,202.26	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility		$1,548.82	$1,548.82	$1,548.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,548.82	Professional		$1,122.02	$1,122.02	$1,548.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $3,019.95 / $6,309.57	Facility		$1,258.93	$3,019.95	$6,309.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,630.27 / $4,677.35	Professional		$1,258.93	$2,630.27	$4,677.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $1,548.82 / $1,905.46	Professional		$75.86	$1,548.82	$1,905.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,995.26 / $2,238.72	Facility		$1,778.28	$1,995.26	$2,238.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,238.72 / $2,238.72	Professional		$1,995.26	$2,238.72	$2,238.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $3,311.31 / $4,786.30	Facility		$1,949.84	$3,311.31	$4,786.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $2,570.40	Professional		$1,862.09	$1,862.09	$2,570.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility		$2,187.76	$2,187.76	$2,187.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,949.84 / $2,511.89	Professional		$1,862.09	$1,949.84	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $3,311.31 / $3,311.31	Facility		$1,000.00	$3,311.31	$3,311.31
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,148.15 / $1,905.46	Professional		$933.25	$1,148.15	$1,905.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,949.84 / $3,388.44	Professional		$1,584.89	$1,949.84	$3,388.44